contraception?
Transcription
contraception?
So you want to know about contraception? Contents 2 Where to get advice and contraception 4 How old do you have to be to get contraception? 5 I don’t want my parents to know 6 Methods of contraception 7 How reliable is my contraception? 7 Contraception at-a-glance 8 Contraceptive methods 10-25 Emergency contraception 26-29 Sexually Transmitted Infections (STIs) 30 Think you might be pregnant? 32 Useful contacts 33 www.bpas.org FACT About BPAS British Pregnancy Advisory Service (BPAS) is the UK’s leading provider of abortion care. Nearly all the women we see have their treatment paid for by the NHS. Every year we treat almost 9,500 teenagers. You can get pregnant the very first time you have sex We also provide contraception, STI testing and vasectomy services. BPAS is a charity. About this booklet If you plan to have sex and don’t want to get pregnant, using contraception is the best way to prevent pregnancy. This booklet explains your contraceptive choices and where to get help and contraception. It contains useful facts about Sexually Transmitted Infections (STIs) and advice about what to do if you think you might be pregnant. BPAS 03457 30 40 30 3 Where to get advice and contraception You can get confidential advice and find out where to get free contraception from: •Brook (if you are under 25) see www.brook.org.uk •NHS National Sexual Health helpline 0300 123 7123 •Family Planning Clinic or Contraceptive and Sexual Health Service see www.fpa.org.uk or www.nhs.uk/worthtalkingabout •Your GP (or another GP if you don’t want to go to your own GP) FACT n All contraceptio is free in the UK 4 www.bpas.org How old do you have to be to get contraception? Anyone can ask for contraception, no matter how old they are. If you are under 16 a doctor, nurse or health worker can prescribe contraception, if they believe you understand the decision you are making. If you feel nervous, you could visit a specialist young person’s service, such as Brook. There are no laws to stop under 16s buying condoms or preventing shopkeepers from selling them to under 16s. You can buy them from chemists, like Boots or Superdrug, larger supermarkets, petrol stations, pubs and vending machines in toilets. Lots of young people’s sexual health services give them away free. Make sure a condoms have e ar d an k ar CE m e th re fo be used te da ry pi ex BPAS 03457 30 40 30 5 I don’t want my parents to know Even if you are under 16, doctors, nurses and other health workers have very strict rules on confidentiality. The law says they have to keep all patient records and information completely private. In really exceptional cases, if they think that you or another person is in serious danger, they might feel there is a need to pass information on, but they would talk to you about it first. FACT Even if you are s have under 16, doctor ng hi you to keep everyt etely tell them compl private 6 www.bpas.org Methods of contraception There are lots of different methods of contraception to choose from and different methods will suit different people. This guide will help you to choose a method that is right for you. How reliable is my contraception? Contraceptive use can either be perfect (always correct) or typical (which usually applies to the average person, as it’s sometimes difficult to use contraception correctly every time). The effectiveness figures for each method used in this booklet are based on typical use during the first year. BPAS 03457 30 40 30 FACT Condoms ot pr ect you from some STIs 7 Contraception at-a-glance Contraceptive implant (Nexplanon®) Is the size of a thin matchstick. A doctor or nurse inserts this under the skin of the upper arm after a local anaesthetic. Lasts for 3 years. Intrauterine system (IUS or Mirena®) A small, T-shaped piece of plastic, which slowly releases a small amount of hormone and lasts for 5 years. Intrauterine device (IUD or coil) A small, T-shaped piece of flexible copper and plastic, which is fitted into the uterus and lasts for 10 years. Contraceptive injection (Depo-Provera®) A hormone injection that stops the ovary from releasing eggs that could be fertilised. It is injected into a muscle and lasts for 12 weeks. Vaginal ring (Nuvaring®) A small, flexible, transparent plastic ring that you put into your vagina like a tampon and is left in place for 3 weeks. Contraceptive patch (Evra®) A 4cm square plastic patch that sticks to the skin and releases hormones into the bloodstream through the skin. Combined birth control pill (The pill) Taken daily to prevent pregnancy. It contains 2 types of hormones similar to those found naturally in a woman’s body. 8 www.bpas.org p. 11 99.9% Effective p. 12 99.8% Effective p. 13 99.2% Effective p. 14 94% Effective p. 15 91% Effective p. 16 91% Effective p. 17 91% Effective Progeston only pill (Mini pill) Taken daily to prevent pregnancy. It contains small amounts of the hormone progestogen. Diaphragm Soft dome shaped piece of flexible rubber or silicone, which fits into the vagina and over the cervix (neck of the womb). Male condom Fits over a hard (erect) penis and is the only contraception that offers good protection against STIs. Female condom Similar to male condoms except they fit inside the vagina rather than over the penis. Withdrawal method When a man pulls his penis out before he ejaculates (cums). He then ejaculates outside the woman’s body. Natural family planning Avoiding sex during the most fertile phase of your monthly cycle (which is quite difficult to do). Sterilisation A permanent form of male or female contraception that prevents pregnancy forever. BPAS 03457 30 40 30 p. 18 91% Effective p. 19 88% Effective p. 20 82% Effective p. 22 79% Effective p. 23 78% Effective p. 24 76% Effective p. 25 (m) 99.9% (f) 99.5% Effective 9 Contraceptive methods You are sure to find contraception to suits you as there are several types to choose from. Long acting reversible contraception (LARC) (Implant, IUD (coil), and IUS) Sometimes called ‘fit and forget’ methods. These are very reliable and you won’t need to do anything until they need replacing several years after fitting. Hormonal contraception (‘The pill’, patch, injection and vaginal ring) Very reliable methods providing they are used exactly as directed. Barrier contraception (diaphragm, male and female condoms) To be used every time you have sex. Natural family planning and withdrawal methods Need lots of self-control and expert teaching and knowledge. Sterilisation (Vasectomy and female sterilisation) Permanent and irreversible surgery. Have a look at the methods in more detail on the following pages. 10 www.bpas.org Contraceptive implant (Nexplanon®) The implant is the size of a thin matchstick and a doctor or nurse inserts it under the skin of the upper arm after a local anaesthetic. They use a needle to insert the implant. It should only take a few minutes and you won’t need any stitches. It releases the hormone progestogen, which stops the ovary from releasing eggs that could be fertilised. 99.9% Effective (fewer than 1 woman in every 100 women using the implant will get pregnant) ADVANTAGES DISADVANTAGES • • • •It can make your periods irregular or stop them altogether • You will be able to feel the implant in your arm •When the implant is first put in, you may experience some bruising, tenderness or swelling •Acne may improve, occur or worsen during use It lasts for 3 years You don’t have to think about contraception every day or every time you have sex Once it’s removed by a doctor or nurse normal fertility returns immediately BPAS 03457 30 40 30 11 Intrauterine system (IUS or Mirena®) The small, T-shaped piece of plastic (approx. 3cm long) slowly releases a small amount of hormone. This hormone thickens the mucus in the cervix (neck of the womb) making it harder for the sperm to enter the womb and fertilise an egg. The IUS is fitted into the uterus (womb) through the vagina by a doctor or nurse. It takes a few minutes to insert and it may hurt a bit, though not for long. 99.8% Effective (fewer than 1 in every 100 women using the IUS will get pregnant) 12 ADVANTAGES DISADVANTAGES • • • • • • • It lasts for 5 years and can be removed at anytime by a doctor or nurse Once fitted you don’t have to think about contraception every day or every time you have sex Normal fertility returns as soon as it is removed by a doctor or nurse Your periods may become light or stop altogether www.bpas.org You may have unpredictable bleeding in the first few months It can cause temporary side effects, such as skin problems or breast tenderness There’s a very small chance of infection after it is inserted Intrauterine device (IUD or coil) The IUD is a small, T-shaped piece of plastic (approx. 3cm long) surrounded by copper, which is fitted into the uterus (womb) through the vagina by a doctor or nurse. It takes a few minutes to insert and it may hurt a bit, though not for long. The IUD doesn’t have any hormones in it like the IUS. It releases copper, which is toxic to sperm. 99.2% Effective (fewer than 1 in every 100 women using the IUD will get pregnant) ADVANTAGES DISADVANTAGES • • • • • • The IUD can be left in place for 10 years or removed at any time by a doctor or nurse Once fitted you don’t have to think about contraception every day or every time you have sex It doesn’t interrupt sex Normal fertility returns as soon as it is removed BPAS 03457 30 40 30 Your periods may become heavier, longer or more painful There’s a very small chance of infection after it is inserted 13 Contraceptive injection (Depo-Provera®) This is an injection containing the hormone progestogen, which stops the ovary from releasing eggs that could be fertilised. It is injected into a muscle, usually the bottom or upper arm and lasts for 12 weeks and then needs to be repeated. 94% Effective (6 in every 100 women using the injection will get pregnant) 14 ADVANTAGES DISADVANTAGES • • • • • • • You don’t have to think about contraception every day or every time you have sex It doesn’t interrupt sex It still works even if you have vomiting or diarrhoea, or are taking antibiotics It is totally reversible It can make your periods irregular or stop You may experience weight gain and if you do have any side effects the injection takes 12 weeks to leave the body, so these side effects may continue for that time It can take a year or more after stopping the injection for regular periods and fertility to return so it might not be suitable if you want to have a baby in the near future www.bpas.org Vaginal ring (Nuvaring®) A small, flexible, transparent plastic ring. You place the ring into your vagina like a tampon and leave it in place for 3 weeks. You shouldn’t feel it when you have sex. You take it out for one week when you will probably get a bleed like a period but you will still be protected against pregnancy. You insert and remove the vaginal ring by yourself at home. The ring uses hormones to stop the release of eggs that could be fertilised. 91% Effective (9 in every 100 women using the vaginal ring will get pregnant) ADVANTAGES • • • • DISADVANTAGES You don’t have to think about contraception every day or every time you have sex It doesn’t interrupt sex because you can have sex with the ring in place Your periods may become regular, lighter and less painful It still works even if you have vomiting or diarrhoea • • • Some medicines can make the contraceptive vaginal ring less effective It can slip out after or during sex, or when you’re constipated. If you replace it within 3 hours you will still be protected You may get temporary side effects like vaginal discharge, headaches and nausea BPAS 03457 30 40 30 15 Contraceptive patch (Evra®) A 4cm square plastic patch that sticks to the skin and releases the same hormones as the combined pill (oestrogen and progestogen), into the bloodstream through the skin. These hormones stop the ovary from releasing eggs, which could be fertilised. The patch is worn continuously for 7 days and then on the 8th day the old patch is removed and a new one is stuck on. The patch should be changed every week for 3 weeks and then you have a patch free week when you will get a bleed like a period. 91% Effective (9 in every 100 women using the contraception patch will get pregnant) ADVANTAGES • No need to think about contraception every day or every time you have sex • Your periods may become regular, lighter and less painful • It works even after vomiting or diarrhoea • It can be stuck out of sight (upper arm, shoulder or bottom) • You can wear it swimming and in the bath • It doesn’t interrupt sex 16 www.bpas.org DISADVANTAGES • • It can cause skin reactions and may fall off without you noticing Taking medicines like antibiotics can make the contraceptive patch less effective Combined birth control pill (The pill) Comes in a packet of small tablets and is taken daily to stop you getting pregnant. It contains 2 types of hormones, oestrogen and progestogen, which are similar to those found naturally in a woman’s body. It works by stopping the ovary from releasing eggs, which could be fertilised. You take one pill every day for 21 days until you finish one pack. Then have a 7 day break when you will get a bleed like a period but you will still be protected against pregnancy during this week. 91% Effective (9 in every 100 women using the combined pill will get pregnant) ADVANTAGES DISADVANTAGES • • • • • • Your periods may become regular, lighter and less painful It doesn’t interrupt sex Some types of pill can also help reduce spots You have to remember to take it every day Missing a pill, vomiting, severe diarrhoea or some medicines can make the pill less effective It may not be suitable if you are very overweight BPAS 03457 30 40 30 17 Progestogen-only pill (Mini pill) Comes in a packet of small tablets and is taken daily to stop you getting pregnant. It contains small amounts of the hormone progestogen but doesn’t contain oestrogen. It thickens the mucus around the cervix (neck of the womb) making it harder for sperm to move through and enter the womb to fertilise an egg. You take one pill every day at the same time until you finish the packet and then start the next packet straight away without a break. 91% Effective (9 in every 100 women using the Progestogen-only pill will get pregnant) 18 ADVANTAGES DISADVANTAGES • Does not interrupt sex •You can avoid some of the side effects you might get with the combined pill because it only contains one hormone • • • You need to take it at the same time every day for it to work properly Your periods may become irregular, be lighter or stop altogether Missing a pill, vomiting, diarrhoea or some medicines can make the pill less effective www.bpas.org Diaphragm/cap with spermicide Diaphragms and caps are made of flexible rubber or silicone and are soft and dome shaped. They fit into the vagina and over the cervix (neck of the womb). They should be used with spermicide (a gel which kills sperm) each time you have sex. The diaphragm blocks the opening to the womb to stop sperm entering. Caps are smaller than diaphragms. 88% Effective (12 in every 100 women using the diaphragm will get pregnant) ADVANTAGES DISADVANTAGES • • • • • • • You can put it in before sex so it doesn’t disturb the moment You shouldn’t be able to feel it when you have sex It’s reusable It can take time to learn to use it correctly It can be messy because you have to use it with spermicide It must be left in place for at least 6 hours after sex before removing and washing it Some women develop cystitis when they use a diaphragm BPAS 03457 30 40 30 19 Male condom Fits over a hard (erect) penis and catches the sperm when a man ejaculates (cums) and stops it from entering the vagina to fertilise an egg. There will be instructions in the packet that you should read carefully before using condoms for the first time. Some condoms are ready lubricated to make them easier to use. 82% Effective (18 in every 100 women using male condoms will get pregnant) MYTH s does Using 2 condom otection. not increase pr es it The friction mak the more likely that rip condom will 20 Use with water-based lubricant, to reduce friction during sex, which means the condom is less likely to tear and may make sex more enjoyable. Always check that your condom is in date and has a Kitemark or CE mark to show it is safe and has been quality tested. www.bpas.org ADVANTAGES DISADVANTAGES •Condoms are the only contraception to offer protection against STIs •Condoms are easy to get hold of and easy to use •They aren’t expensive and you can often get them for free •Condoms make sex less messy by catching the sperm •They come in different shapes, sizes and flavours, which can make sex more fun • They can split or slip off • They can interrupt sex •Oil-based products (like body oils, hand creams and Vaseline) can damage the latex and make the condom more likely to split, so always use water-based lubricant Busted excuses for not using a condom: ‘I’m healthy’ Many people with sexually transmitted infections have no symptoms. Just because you can’t see any obvious symptoms, such as sores or warts, doesn’t mean that you’re free from STIs. ‘I like it natural’ Sex with a condom can feel natural. With the new superfine condoms, you often can’t tell that you’re using one. ‘I can’t be bothered’ “If you can’t be bothered to use a condom then I can’t be bothered to have sex with you.” Condoms don’t just cut the risk of pregnancy or infections. They can help both of you to have more fun in bed. Try a coloured condom for some fun, a textured condom for extra sensation, or a flavoured condom for oral sex. ‘They hurt’ or ‘they’re too small’ A condom that’s too tight may feel uncomfortable. But condoms come in a range of sizes, so you can easily find one that fits properly. BPAS 03457 30 40 30 21 Female condom Female condoms are similar to male condoms except they fit inside the vagina rather than over the penis. They line the vagina to stop sperm getting into it. They are also wider than a male condom. They are held in place with a ring that lies outside the vagina. There will be instructions with the packet, which you should read carefully before using female condoms for the first time. 79% Effective (21 in every 100 women using female condoms will get pregnant each year) 22 ADVANTAGES DISADVANTAGES • • • They can slip or get pushed out of place if they aren’t used properly • They can be quite expensive to buy They protect against STIs as well as pregnancy They can be put in anytime before sex www.bpas.org Withdrawal method When a man pulls his penis out before he ejaculates (cums). He then ejaculates outside the woman’s body. This is a poor way to prevent pregnancy as some sperm can leak out of the penis before ejaculation. 78% Effective (22 in every 100 women using withdrawal will get pregnant each year) ADVANTAGES FACT • Doesn’t involve taking any hormones or using any devices DISADVANTAGES • It has a really high failure rate • Requires lots of control and practice BPAS 03457 30 40 30 s becomes When the peni aks a tiny le erect (hard) it , which id amount of flu is enough is Th . contains sperm nancy even if to result in preg aculate (cum) a man doesn’t ej r’s vagina inside his partne 23 Natural family planning This is when you identify the most fertile phase of your monthly cycle using natural signs, such as body temperature, cervical secretions and the length of your menstrual cycle. Vaginal sex is avoided or condoms are used during this fertile time. You should only use natural family planning if you have been taught by a specialist. Every woman is different and natural family planning needs to be understood really well if it is going to be effective. 76% Effective (24 in every 100 women using natural family planning will get pregnant each year) DISADVANTAGES ADVANTAGES • • 24 It can help you recognise normal and abnormal vaginal secretions Doesn’t involve taking any hormones or using any devices • • • • • It has a really high failure rate It takes time to learn the method and there are not many qualified to teach it You have to keep daily records You need to avoid sex or use condoms during the fertile time Illness, stress or travel can make the fertility signs harder to read www.bpas.org Sterilisation This is a permanent form of contraception that will prevent pregnancy forever. It’s only suitable for people who never want children, or who do not want any more children. Men and women can both be sterilised. Men have the tubes, which carry the sperm, tied or sealed so that there is no sperm in their semen when they ejaculate (cum). This is called a vasectomy. Women have an operation to cut or block the tubes between the ovary and the womb (fallopian tubes) so that the eggs released by the ovary can’t reach the womb. (m) 99.9% (f) 99.5% Effective BPAS 03457 30 40 30 25 Emergency contraception Emergency contraception can be used to help prevent an unwanted pregnancy. If your contraception fails (you forget to take your pill or the condom splits), or you didn’t use contraception at all, you need to act fast. There are 2 types of emergency contraception – the emergency contraceptive pill (morning after pill) and the copper IUD (coil). Make sure you get advice on emergency as contraception ! le ib ss soon as po 26 www.bpas.org Emergency contraceptive pill These work by preventing or delaying the release of an egg from the ovary. It may also affect the womb lining so a fertilised egg cannot settle there. There are 2 kinds of morning after pill – Levonelle® and ellaOne®. Levonelle® can be taken up to 3 days after unprotected sex, but the sooner you take it the more likely it is to work. If it is taken within 24 hours after sex it reduces the risk of pregnancy by 95%. ellaOne® can be taken up to 5 days after unprotected sex. It is believed to be more effective than Levonelle® and works just as well at any time within the 5 day period. It is only available with a prescription. BPAS 03457 30 40 30 27 Where to get the EC pill You can get the emergency contraceptive pill at any of the following places: These services are free to all, including under 16s. • Brook centres (for under 25s) For their contact details see page 33. • Young people’s services If you’re over 16, you can also buy Levonelle® from most pharmacies. • A GP • NHS walk-in centres • Most sexual health/GUM clinics • Some accident and emergency departments FACT • Some pharmacies 28 raception Emergency cont sexually t will not preven ctions. fe transmitted in ha If you have d x, you unprotected se er id ns should co st te an STI www.bpas.org Emergency intrauterine device (IUD) The IUD, sometimes called the ‘coil’, is a small, T-shaped piece of plastic (approx. 3cm) surrounded by copper which is inserted into the uterus (womb) through the vagina by a doctor or nurse. The IUD can be fitted at: It can be fitted as an emergency contraceptive up to 5 days after unprotected sex or up to 5 days after the expected date of ovulation. Check with your chosen service to see if they fit IUDs and find out whether a suitably trained doctor or nurse will be available to fit the IUD when you attend. See page 33 for contact details. • Most Brook centres • Family planning clinics • Some GPs See page 13 for more information about the IUD. The IUD works by stopping an egg from being fertilised or implanted in the uterus. The IUD is the most effective form of emergency contraception and can be kept as a regular method of contraception for up to 10 years. BPAS 03457 30 40 30 29 Sexually Transmitted Infections (STIs) What are they? Sexually transmitted infections (STIs) are infections that spread through sexual contact. STIs can be passed on through any kind of unprotected sex (anal, vaginal and oral sex). Some STIs show signs a few days after infection, while many have no symptoms at all. If you don’t know you are infected and you don’t get treated, they can cause serious problems later on in life. See www.bpas.org/bpasyoungpeople to view our “So you want to know about STIs” booklet. 30 www.bpas.org Get tested An STI won’t go away without treatment, but most STIs can be easily treated with antibiotics. It’s simple to get tested and it’s free. If you think you might have an STI you should attend your local sexual health clinic. Call 0300 123 7123 or visit www.nhs.uk/worthtalkingabout to find a clinic near you. Tests for STIs vary. Some are samples taken from inside the vagina or tip of the penis using a swab (cotton wool bud). You may be able to take the sample yourself, or a nurse or doctor may do this for you. Other STI tests require a sample of urine or blood. Chlamydia is the most common STI in the UK with sexually active young people most at risk of infection. It often has no symptoms but may cause fertility problems, if it is not treated. You may be able to get a free chlamydia test through the post where you live. Visit www.freetest.me.uk for more information. FACT le way to The best possib lf against protect yourse condom. STIs is to use a to put a To find out how condom on visit an bpas.org/bpasm BPAS 03457 30 40 30 31 Think you might be pregnant? If you think you might be pregnant the first thing to do is find out whether you really are. A pregnancy test is the most reliable way to find out if you are pregnant. You can have a FREE pregnancy test at: • Brook centres If the test is positive and you have an unplanned pregnancy you have three choices: • Family Planning Clinics • Continue with the pregnancy and become a parent • Some sexual health or genitourinary medicine (GUM) clinics • Continue with the pregnancy and seek adoption • GP surgery/practice See opposite for details on how to contact them. 32 Most pharmacies and major supermarkets sell home pregnancy tests, costing less than £5. These are reliable as long as you follow the instructions carefully. • End the pregnancy with abortion For more information please visit our website www.bpas.org www.bpas.org Useful contacts BPAS At BPAS we provide pregnancy testing, emergency contraception, counselling for unplanned pregnancy and abortion treatment. Most of the women we see have their treatment paid for by the NHS. Call 03457 30 40 30. Open 7 days a week, 24 hours a day. www.bpas.org Brook Provides free and confidential sexual health advice and contraception for anyone under 25. The website has tons of useful information. www.brook.org.uk Worth Talking About (for under 19s) Whether it’s knowing about your contraceptive choices, explaining STIs, coping with emotions or understanding your body, you’ll find straightforward information and advice here. Helpline 0300 123 2930. www.nhs.uk/worthtalkingabout fpa (Family Planning Association) fpa works to improve sexual health awareness across the UK. For advice on contraception, pregnancy choices, abortion and STIs visit www.fpa.org.uk NHS national sexual health helpline NHS Providing information and advice on contraception, sexual health and local services. Call 0300 123 7123 or see www.nhs.uk BPAS 03457 30 40 30 33 Notes 34 www.bpas.org Notes BPAS 03457 30 40 30 35 BPAS - here if you need us. 03457 30 40 30 www.bpas.org Head Office: 20 Timothys Bridge Road, Stratford Enterprise Park, Stratford-Upon-Avon, CV37 9BF T: 0345 365 50 50 or +44 1789 508 211 Registered Charity 289145 as British Pregnancy Advisory Service BPAS is registered and regulated by the Care Quality Commission PRI-YOU-515 Issue 6 May 2015 NOTE TO PRINTER: PLEASE INSERT FSC LOGO HERE